Dress Down Day, Doctor's appearance

Doctors Should Not Dress Like Used-Car Salesmen

ByDr. Gifford JonesThursday, October 7, 2010

“Thank God it’s Friday.” That’s an expression we often hear in the workplace. Friday was once “dress down” day and everybody loved the relaxed dress code at the end of the week. Now it’s relaxed clothing every day of the week. I have no idea how this casualness has affected the efficiency of the business community. But dressing-down has had an effect on how patients judge their doctors.

Dr. Matt Kanzler and his colleagues recently reported a study in the Archives of Dermatology. They conducted a survey on 84 patients from a private practice setting along with 191 patients attending a county hospital clinic. And there were some surprising findings.

Studies show that racial discrimination still occurs in many segments of our society. But when it came to judging their doctor the majority of patients cared less whether their physician was white, black, Asian, young or old. That was refreshing news.

But when asked about their doctor’s attire it was a different matter. Patients left little doubt that they expected their doctor and staff to dress in what is best known as a professional manner. In effect, jeans and sandals were out. White coats, dress pants and name badges were in.

What surprised Dr Kanzler was that the findings were virtually the same regardless of age, race, economic or social status. He originally expected that the doctor’s appearance would be much more important to older patients. But this was not the case.

So why the worry about their doctor’s attire when other workers can dress down? Dr. Kanzler admits there’s no easy answer. But the study suggest the doctor-patient relationship is the reason, and the trust that must be part of that association.

Patients, the study shows, perceive a well-dressed doctor as being more meticulous and serious about his or her work. They worry that a doctor who appears slovenly may also be haphazard in caring for them.

Several years ago another study came to the same conclusion. Researchers asked patients to assess pictures of doctors dressed in different attire. The majority of patients chose the doctor in white coat and tie.

I don’t think these findings come as a great surprise. Choosing a doctor is not like choosing a used car salesman. After all, it’s your life that’s on the line and no patient takes that lightly.

Patients know a doctor isn’t merely going to shake their hand. He or she is responsible for deciding on laboratory tests, X-ray studies or whether a second opinion is needed. And if patients have a serious disease his decision one way or another may be vital to their survival.

I see doctors, both young and old, who don’t care about dress. They say, “judge me by what I know, not on how I look”. It appears that most patients simply don’t buy this approach.

But there are times when patients must forget about their doctor’s attire and even his personality. Since I’ve spent my life in surgery I’m well aware that not often do surgical skill and a jocular personality go together. Surgery is serious business. It’s skill, not social niceties we should look for.

I recall one famous surgeon who was far from being noted for sartorial splendor. Rather, he always wore disheveled clothing that even a used-car salesman would have tossed out. And to make matters worse he had the morose personality of Dracula. But I often referred patients to him.

I warned patients in advance of these facts. I reminded them that this specific surgeon was the best one for that particular operation. That he was merely doing a technical procedure and that his technical dexterity, not his dress or personality, were going to cure them.

I’ve no doubt that “dressing down” is here to stay in our society just as “dumbing down” has become the norm for television. But hopefully physicians will begin to get the message that professional attire is what patients expect and that it’s a function of the trust necessary to ease their anxieties. Shakespeare was right when he wrote centuries ago that “The apparel oft proclaims the man”.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He’s been a ship’s surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: http://www.mydoctor.ca/gifford-jones

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